1457687550 NPI number — RICHARD DO, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457687550 NPI number — RICHARD DO, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD DO, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RICHARD DO, O.D.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457687550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5631 S 150TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUKWILA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98188-7782
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-383-4939
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16502 MERIDIAN E
Provider Second Line Business Practice Location Address:
WAL-MART VISION CENTER
Provider Business Practice Location Address City Name:
PUYALLUP
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98375-2515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-446-1760
Provider Business Practice Location Address Fax Number:
253-446-1762
Provider Enumeration Date:
10/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DO
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
206-383-4939

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OD.60113728 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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